Provider Relations Rep I/II
Bcidaho

Job Info

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Blue Cross of Idaho is looking for Provider Relations Representative to serve as the liaison and maintain open communication between Blue Cross of Idaho (BCI) and the providers of health care services regarding company policies and payment procedures, facilitate proper claim submission, provide contracting information for all lines of business, and to identify potential problem areas.

We are looking for a Provider Relations Rep with:
Provider Relations Rep I:

• Experience: 4 years' provider service or health industry experience
• Education: High School or equivalent

Provider Relations Rep II:

• Experience: 8 years' provider service or health industry experience
• Education: High School or equivalent

We would like knowledge and experience with the Medicare Medicaid Coordinated Plan (MMCP) and Idaho Medicaid Plus (IMP) programs.

What your day may look like:

• Coordinate the resolution of provider contracts, agreements, fee schedules, and payment problems.
• Collaborate with key stakeholders to identify and resolve issues.
• Coordinate resolution of contract or agreement issues. Communicates critical issues and provides recommendations to leaders.
• Educate providers on policies, procedures, practices, and data integrity. Ensures providers are informed on changes/updates to policies, procedures, and practices.
• Ensure department and provider compliance with regulatory agencies.
• Coordinate cross departmental activities and projects to support and adhere to the provider contract requirements.
• Perform research to respond to inquiries and interprets policy and procedures to determine effective response.
• Provide welcome information to newly contracted providers.
• Promote provider participation in on-line tools and programs available.
• Perform other duties and responsibilities as assigned.

Pay Grade: 18/20

Reasonable accommodations
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.

This job has expired.